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Biomedical subjects

K R Neal

Publications and source records attributed to K R Neal.

52 records · Page 3Linked to original sources
PubMed1996

The presence of rheumatoid factor in sera from anti-HCV positive blood donors interferes with the detection of HCV-specific IgM. Trent HCV Study Group.

BACKGROUND/AIMS: IgM anti-HCV has been reported as a useful marker of disease activity and of likely response to interferon therapy in patients with chronic hepatitis C virus infection. Sera from patients with hepatitis C virus infection may contain rheumatoid factor. This study was designed to investigate the possible effect of rheumatoid factor in an IgM anti-HCV assay. METHODS: Sera from 75 blood donors with chronic hepatitis C virus infection were tested for the presence of IgM anti-HCV using a core-derived peptide as antigen, before and after removal of IgG. These sera and appropriate control sera were also tested for the presence of rheumatoid factor. RESULTS: Removal of IgG prior to IgM testing resulted in a significant loss of reactivity in the IgM anti-HCV assay in 30/41 sera that were positive in this assay when tested untreated. Seventy per cent of anti-HCV positive sera were also positive for rheumatoid factor. CONCLUSIONS: Rheumatoid factor causes significant false positive reactivity in IgM anti-HCV detection assays. The results of assays that do not account for this interference should be viewed with caution.

Antibody Specificity↗
PubMed1996

Differences in post-operative infection rates between patients receiving autologous and allogeneic blood transfusion: a meta-analysis of published randomized and nonrandomized studies.

We have undertaken a meta-analysis of the post-operative infection rates in patients who received autologous blood compared with allogeneic blood. Nine studies published after 1989 were identified, of which seven had sufficient data on transfusion given in the paper to be included, giving a total of 1060 patients. The risk of post-operative infection was greater in the allogeneic group, odds ratio 2.37 (95% confidence interval (CI) 1.6-3.6, P < 0.0001) compared with the autologous group. Allogeneic and autologous blood transfusion should be compared in a large multicentre randomized control trial.

Blood Transfusion↗
PubMed1995

The autumn peak in campylobacter gastro-enteritis. Are the risk factors the same for travel- and UK-acquired campylobacter infections?

BACKGROUND: In the autumn of 1992 there was an excess of campylobacter cases in Nottingham compared with the national average. No relative increase was seen for salmonella infections. METHODS: A case-control study with a postal questionnaire was carried out to determine exposure to possible risk factors. The patients were 282 laboratory confirmed cases of campylobacter and 318 culture negative controls who had submitted a faeces specimen. All patients were aged 18 or older. The main outcome measures were relative risks for campylobacter infection compared with controls with a negative faeces culture. RESULTS: Twenty-five per cent of cases were associated with foreign travel. Eating chicken and handling raw poultry were the main risk factors for UK-acquired infections. The number of cases with a history of contact with puppies or drinking milk that was either unpasteurized or from bottles with bird-damaged tops was small. CONCLUSION: Eating chicken and handling raw poultry are the main risk factors for campylobacter infections. Contact with puppies or drinking potentially infected milk can explain only a small percentage of campylobacter infections. Risk factors for infection acquired abroad follow a different pattern compared with UK-acquired cases.

Adult↗
PubMed1994

Risk factors for hepatitis C virus infection. A case-control study of blood donors in the Trent Region (UK).

The introduction of screening for hepatitis C virus (HCV) by the National Blood Transfusion Service identified donors who had acquired HCV infection. We undertook a case-control study amongst blood donors in the Trent Region to determine risks for HCV infection. A total of 74 blood donors confirmed positive for hepatitis C infection and 150 age, sex and donor venue matched controls were included in the study. Fifty-three percent of hepatitis C infected blood donors reported previous use of injected drugs compared to no controls; relative risk (RR) not estimatable (lower limit 95% CI = 20). Other risk factors were a history of: receipt of a blood transfusion or blood products RR = 3.6 (95% CI 1.5-8.3), having been a 'health care worker' RR = 2.8 (95% CI 1.1-7.6), tattooing RR = 3.3 (95% CI 1.2-8.7), and an association with having been born abroad RR = 3.2 (95% CI 1.1-9.5). No risk was shown for a history of multiple sexual partners, ear piercing or acupuncture. Injecting drug use explains more than 50% of hepatitis C infections in blood donors, a group who are less likely to have injected drugs than the general population.

Adult↗
PubMed1994

Failure of the revised pre-donation guidelines to prevent people with a history of high-risk behaviour from donating blood.

We have evaluated the effectiveness of the alteration in the literature aimed at the self-exclusion of blood donors with a history of high-risk behaviour. Since the introduction of anti-HCV screening on 1 September 1991 all HCV-positive donors in the Trent Region have been invited for interview by Blood Transfusion medical staff to ascertain risk factors for HCV infection. We have compared the 5-month periods before (1 September, 1992 to 31 January, 1993) and after (1 February, 1993 to 30 June, 1993) the introduction of the amended literature on 1 February, 1993. No differences between the two time periods were noted for the prevalence rate of HCV infection amongst new or repeat donors, or history of risk factors or specific exclusion criteria. The new literature is failing to exclude people with a history of high-risk behaviour from donating blood and further study of this problem is urgently required.

Adult↗
PubMed1989

Infective respiratory exacerbations in young adults with cystic fibrosis: role of viruses and atypical microorganisms.

Thirty six adults with cystic fibrosis were studied over one year to determine the incidence of infection with respiratory viruses and atypical organisms. Nineteen patients entered the study during an acute exacerbation of respiratory symptoms with an increase in purulent sputum production, cough, or breathlessness accompanied by a fall in FEV1 (group 1); 17 patients entered when they were stable both clinically and in terms of lung function values (group 2). Group 1 patients had a mean of 2.6 (range 1-4) infective exacerbations during the year and group 2 patients a mean of 1.1 (0-2) exacerbations. Eleven patients developed serological evidence of viral (influenza virus A and B, cytomegalovirus, human rhinovirus 2, adenovirus) or Mycoplasma pneumoniae infection. There was no difference in seroconversion rates between group 1 (five patients) and group 2 (six patients). There was a weak association between viral seroconversion and the isolation of Pseudomonas aeruginosa from sputum, though this was not significant.

Adolescent↗
PubMedDate not supplied

Integration between general and geriatric medicine: a needs related policy.

A joint admitting policy between a general physician and a physician in medicine for the elderly reduced the length of stay in acute medical beds by 25% without increasing the length of stay in rehabilitation beds. The basis for the cooperation was not related to age but rather to the perceived needs of the patient on admission. This method of integration between medicine and geriatrics could be implemented in most hospitals.

Age Factors↗